Evidence map›Paper›PMID 35775814›Full record

Observational studyEuropean heart journal. Cardiovascular Imaging2023

Distinct cardiovascular phenotypes are associated with prognosis in systemic sclerosis: a cardiovascular magnetic resonance study.

Daniel S Knight, Nina Karia, Alice R Cole, Rory H Maclean, James T Brown, Ambra Masi, Rishi K Patel, Yousuf Razvi, Liza Chacko, Lucia Venneri and 10 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European heart journal. Cardiovascular Imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Daniel S KnightNational Pulmonary Hypertension Service, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.ORCID 0000-0002-0512-3961
Nina KariaNational Pulmonary Hypertension Service, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.ORCID 0000-0002-0107-7064
Alice R ColeCentre for Rheumatology and Connective Tissue Diseases, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
Rory H MacleanCentre for Rheumatology and Connective Tissue Diseases, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
James T BrownNational Pulmonary Hypertension Service, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.
Ambra MasiUCL Department of Cardiac MRI, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
Rishi K PatelUCL Department of Cardiac MRI, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.ORCID 0000-0002-3177-5680
Yousuf RazviUCL Department of Cardiac MRI, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.ORCID 0000-0003-4766-3293
Liza ChackoUCL Department of Cardiac MRI, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
Lucia VenneriUCL Department of Cardiac MRI, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
Tushar KotechaNational Pulmonary Hypertension Service, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.ORCID 0000-0003-0059-4817
Ana Martinez-NaharroUCL Department of Cardiac MRI, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
Peter KellmanNational Heart, Lung, and Blood Institute, National Institute of Health, 31 Center Dr, Bethesda, MD 20892, USA.ORCID 0000-0002-9875-6070
Ann M Scott-RussellDepartment of Rheumatology, Queen Alexandra Hospital, Cosham, Portsmouth, PO6 3LY, UK.
Benjamin E SchreiberNational Pulmonary Hypertension Service, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.
Voon H OngCentre for Rheumatology and Connective Tissue Diseases, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.
Christopher P DentonCentre for Rheumatology and Connective Tissue Diseases, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.ORCID 0000-0003-3975-8938
Marianna FontanaUCL Department of Cardiac MRI, University College London (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK.ORCID 0000-0002-9233-9831
J Gerry CoghlanNational Pulmonary Hypertension Service, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK.
Vivek MuthuranguUCL Institute of Cardiovascular Science, University College London, Gower Street, London, WC1E 6BT, UK.

Funding

Gadgetron Global Network and Artificial Intelligence Powered Cardiac ImagingZIAHL006242 · NHLBI · NATIONAL HEART, LUNG, AND BLOOD INSTITUTE · PI KELLMAN, PETER · 2019 to 2023
$2.2M
British Heart Foundation FS/CRLF/20/23004British Heart Foundation NH/18/1/33511British Heart Foundation PG/17/47/32963
6 · The paper itself

Abstract

aimsCardiovascular involvement in systemic sclerosis (SSc) is heterogeneous and ill-defined. This study aimed to: (i) discover cardiac phenotypes in SSc by cardiovascular magnetic resonance (CMR); (ii) provide a CMR-based algorithm for phenotypic classification; and (iii) examine for associations between phenotypes and mortality. METHODS AND

resultsA retrospective, single-centre, observational study of 260 SSc patients who underwent clinically indicated CMR including native myocardial T1 and T2 mapping from 2016 to 2019 was performed. Agglomerative hierarchical clustering using only CMR variables revealed five clusters of SSc patients with shared CMR characteristics: dilated right hearts with right ventricular failure (RVF); biventricular failure dilatation and dysfunction (BVF); and normal function with average cavity (NF-AC), normal function with small cavity (NF-SC), and normal function with large cavity (NF-LC) sizes. Phenotypes did not co-segregate with clinical or antibody classifications. A CMR-based decision tree for phenotype classification was created. Sixty-three (24%) patients died during a median follow-up period of 3.4 years. After adjustment for age and presence of pulmonary hypertension (PH), independent CMR predictors of all-cause mortality were native T1 (P < 0.001) and right ventricular ejection fraction (RVEF) (P = 0.0032). NF-SC and NF-AC groups had more favourable prognoses (P≤0.036) than the other three groups which had no differences in prognoses between them (P > 0.14). Hazard ratios (HR) were statistically significant for RVF (HR = 8.9, P < 0.001), BVF (HR = 5.2, P = 0.006), and NF-LC (HR = 4.9, P = 0.002) groups. The NF-LC group remained significantly predictive of mortality after adjusting for RVEF, native T1, and PH diagnosis (P = 0.0046).

conclusionWe identified five CMR-defined cardiac SSc phenotypes that did not co-segregate with clinical data and had distinct outcomes, offering opportunities for a more precision-medicine based management approach.

Indexed as

Heart FailureHypertension, PulmonaryScleroderma, SystemicHumansMagnetic Resonance Imaging, CineMagnetic Resonance SpectroscopyPredictive Value of TestsPrognosisRetrospective StudiesStroke VolumeVentricular Function, Rightcardiovascular magnetic resonancecluster analysisprognosispulmonary hypertensionsystemic sclerosisT1 mapping

Identifiers

PMID35775814
PMCPMC10029850

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.